More nurses in 4J schools?

Here’s a notice sent out this morning (March 6) from District 4J’s communications coordinator, Kerry Delf:

Next year, the Eugene School District will change how it provides school nursing services, moving away from a model that concentrates resources in four school-based health clinics located on high school campuses, in order to funnel more support to elementary and middle school students.

The district currently operates school-based health centers at Churchill, North Eugene, Sheldon and South Eugene High Schools. 4J provides approximately $789,000 per year in operating support. Additional funds come from state funding, grants, donations and billings for service.

The district is considering whether a community medical provider could operate at least one school-based health center next year. “We recognize that our school-based health centers have allowed many students to have easy access to medical and mental health services right on their school campus,” said Cheryl Linder, director of 4J’s Education Support Services. “At the same time, we have a growing number of elementary and middle school students with chronic health conditions requiring nursing support.”

The district now has just over four full-time nursing positions assigned to cover 26 elementary and middle schools. That equates to 2,471 students for every school nurse.

Seven more nursing positions will be added next year, bringing the total to 11.65 full time equivalent nurses to serve the district’s nearly 16,000 students. Each high school will retain a school nurse. A nurse will also be assigned to serve each middle school and its two feeder elementary schools. The student-to-nurse ratio will be about 1,355 students per nurse. The National Association of School Nurses and Centers for Disease Control and Prevention recommend a ratio of 750 students per school nurse.

Many school districts have health clinics staffed by nurse practitioners and sometimes physicians and mental health therapists that can diagnose and treat some conditions, but the Eugene School District’s model has been unique. Eugene has one clinic at each of its high schools. The four clinics are staffed and operated by the school district, and heavily supported by the district’s operating budget. It is more typical for a school district to have fewer school-based health clinics, operated by an outside medical provider rather than the school district. For example, the Salem-Keizer and Hillsboro school districts each have only one school-based health clinic to serve students and families.

“The vision that prompted the district to provide a health clinic in each high school is certainly desirable, but it’s no longer financially sustainable nor does it meet the needs of our younger students today,” Linder said.

District staff began to consider other models for providing student health services this fall, prompted in part by new state requirements that would require the district to invest in new billing and electronic health records systems to meet state requirements. Grant funding to help support the clinics has declined and fewer students are now served at the clinics than in past years. That’s likely because the Oregon Health Plan now covers more students who were previously uninsured and underinsured, allowing better access to physicians and medical care.

“By reallocating resources, we can significantly increase the number of school nurses, improve the health services we provide to our younger students, and focus on helping our students and families access physicians and healthcare services in our community,” Linder said. “At the same time, we’re saddened to tell many valuable staff members that we won’t have clinic jobs for them in the future.”